Coding and Clinical Validation Auditor
Are you a detail-oriented individual with a passion for healthcare and technology? Do you have a strong background in coding and clinical validation? UnitedHealth Group is seeking a talented individual like you to join our team as a Coding and Clinical Validation Auditor. In this role, you will play a critical role in ensuring the accuracy and compliance of our coding and billing processes. We are looking for someone who is dedicated to quality, has excellent analytical skills, and is able to work collaboratively with various teams. If you are looking for a challenging and rewarding opportunity in the healthcare industry, we encourage you to apply for this position.
- Conduct thorough reviews of medical records, claims, and coding documentation to ensure accuracy and compliance with industry standards and regulations
- Utilize coding expertise and knowledge of clinical guidelines to identify errors and discrepancies in coding and billing processes
- Collaborate with coding and billing teams to provide feedback and support for improving accuracy and compliance
- Stay informed of changes in coding guidelines and regulations and apply them to auditing processes
- Communicate effectively with internal and external stakeholders regarding audit findings, recommendations, and corrective actions
- Use data and analytical skills to identify trends and patterns in coding errors and develop strategies for improving overall accuracy
- Maintain detailed and organized records of auditing activities and findings for reporting and documentation purposes
- Train and educate coding and billing staff on coding best practices and compliance guidelines
- Participate in quality improvement initiatives and provide suggestions for process improvements
- Adhere to company policies and procedures, as well as industry standards and regulations related to coding and billing.
Extensive Knowledge Of Coding Guidelines And Healthcare Documentation: A Successful Candidate For This Position Should Have A Deep Understanding Of Coding Guidelines, Including Icd-10, Cpt, And Hcpcs Coding Systems, As Well As Experience With Medical Terminology And Healthcare Documentation.
Coding Certification: A Coding And Clinical Validation Auditor Should Hold A Coding Certification, Such As Cpc, Ccs, Or Ccs-P, From Recognized Organizations Like Aapc Or Ahima. This Demonstrates A Strong Understanding Of Coding Principles And Guidelines.
Experience In Clinical Validation: Unitedhealth Group Is Seeking Candidates With Experience In Clinical Validation, Including Reviewing Medical Records To Ensure That The Documentation Supports The Codes Assigned. This Includes Knowledge Of Coding And Documentation Requirements For Various Settings, Such As Inpatient, Outpatient, And Physician Office.
Strong Analytical Skills: The Role Of A Coding And Clinical Validation Auditor Requires A High Level Of Analytical Skills To Review Large Amounts Of Data And Identify Any Discrepancies Or Potential Issues. The Ability To Think Critically And Problem-Solve Is Crucial For This Position.
Communication And Interpersonal Skills: As A Coding And Clinical Validation Auditor, You Will Be Working Closely With Various Stakeholders, Including Physicians, Coding Staff, And Other Healthcare Professionals. Therefore, Strong Communication And Interpersonal Skills Are Essential To Effectively Convey Audit Findings And Collaborate With Team Members.
Analytical skills
Attention to detail
Compliance regulations
Medical Terminology
Revenue cycle management
Cpt Coding
Clinical Knowledge
Auditing Techniques
Coding Proficiency
Icd-10 Coding
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
Teamwork
Active Listening
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Coding and Clinical Validation Auditor in Raleigh, NC, USA is $65,000 - $80,000 per year. This can vary depending on factors such as experience, education, and specific job duties.
Apply with Video Cover Letter Add a warm greeting to your application and stand out!
UnitedHealth Group Incorporated is an American for-profit managed health care company based in Minnetonka, Minnesota. UnitedHealth Group, Inc. provides health care coverage, software and data consultancy services. It operates through the following segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment utilizes Optum's capabilities to help coordinate patient care, improve affordability of medical care, analyze cost trends, manage pharmacy benefits, work with care providers more effectively, and create a simpler consumer experience.
Get interviewed today!
JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.
Get Started